Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia.
Department of Pediatric Pulmonology and Pediatric Critical Care Medicine, School of Medicine, Universidad El Bosque, Bogotá, Colombia.
J Investig Med. 2018 Aug;66(6):986-991. doi: 10.1136/jim-2018-000708. Epub 2018 Mar 26.
Among inpatients suffering from bronchiolitis, approximately a quarter may undergo a prolonged length of stay (LOS) for the treatment of their respiratory condition. However, there have been few research studies that have evaluated variables that may be associated with a prolonged LOS in these patients, especially in low-income and middle-income countries, where the clinical and economic burden of the disease is the greatest. In an analytical single-center cross-sectional study, we included a population of patients with acute bronchiolitis hospitalized between March and June 2016. We collected demographic and clinical information and the LOS of each patient. Prolonged LOS for bronchiolitis was defined as at least one hospital stay of 5 or more days. A total of 303 patients were included, with 176 (58.1%) male and a median (IQR) age of 3.0 (1.0-7.0) months. After controlling for gender, history of bronchopulmonary dysplasia, number of days with respiratory symptoms, the presence of apnea as an initial manifestation of bronchiolitis, and other underlying disease conditions, we found that the independent predictors of prolonged LOS for bronchiolitis in our study population included age (OR 0.92; 95% CI 0.84 to 0.99; p=0.049), history of prematurity (OR 6.34; 95% CI 1.10 to 36.46; p=0.038), respiratory syncytial virus isolation (OR 1.92; 95% CI 1.02 to 3.73; p=0.048), and initial oxygen saturation (OR 0.94; 95% CI 0.88 to 0.98; p=0.048). The factors identified should be taken into account when planning policies to reduce the duration of hospital stay in infants with bronchiolitis.
在患有细支气管炎的住院患者中,约有四分之一可能因治疗呼吸道疾病而延长住院时间(LOS)。然而,很少有研究评估可能与这些患者 LOS 延长相关的变量,特别是在低收入和中等收入国家,这些国家的疾病临床和经济负担最大。在一项分析性单中心横断面研究中,我们纳入了 2016 年 3 月至 6 月期间因急性细支气管炎住院的患者人群。我们收集了患者的人口统计学和临床信息以及每位患者的 LOS。细支气管炎的 LOS 延长定义为至少一次住院 5 天或以上。共纳入 303 例患者,其中 176 例(58.1%)为男性,中位(IQR)年龄为 3.0(1.0-7.0)个月。在校正性别、支气管肺发育不良史、呼吸症状持续天数、呼吸暂停作为细支气管炎初始表现以及其他潜在疾病后,我们发现我们研究人群中细支气管炎 LOS 延长的独立预测因素包括年龄(OR 0.92;95%CI 0.84 至 0.99;p=0.049)、早产史(OR 6.34;95%CI 1.10 至 36.46;p=0.038)、呼吸道合胞病毒分离(OR 1.92;95%CI 1.02 至 3.73;p=0.048)和初始氧饱和度(OR 0.94;95%CI 0.88 至 0.98;p=0.048)。在制定政策以缩短细支气管炎婴儿住院时间时,应考虑到确定的这些因素。